When the Air Hits Your Brain - My Thoughts

When I was walking back to my car after one of my shifts this past summer at UC Davis Medical Center, I had brief small-talk with a surgery resident. He asked me what services I had been on and what I was interested in the most. When I mentioned neurosurgery, he suggested I look When the Air Hits Your Brain by Frank Vertosick, Jr., M.D. He was a surgeon, and I a lowly pre-med student, so of course I wrote down his advice as if he were God and I was Noah and the ran showers were starting. I started reading it a couple weeks ago, and finished within a few days. Here are my impressions.

Dr. Vertosick begins at the beginning of his medical career: medical school and how he became interested in neurosurgery. His reasoning was more than a little odd to me. Neursurgery was his first rotation in his third year of medical school. At the time he saw the specialty and the work involved in it as boring and tedious, and there was no strong consideration during to pursue it as a post-graduate option. Still, there are stories he remembers from the rotation, one of which had significant importance. One day he was doing a physical on a patient who had been admitted for the removal `of a herniated cervical disk in his neck. Frank noticed that the man's pupils were aymmetrical. That, coupled with some other key symptoms, led Frank to believe the patient didn't have a herniated disk at all, but a tumor. He reported his finding to the resident physician and was able to save the man from an unnecessary and potentially harmful procedure. Some months later, the director of neurosurgery called Frank the Med Student in for a meeting and offered him one of the two neurosurgery intern positions after graduation for his 'good eye.' Frank said he had to think about it. Later, while working in the immunology lab for a side research project, Frank was moving materials under a microscope, where the slight tremors in his hands were exacerbated. The lab technician teased him about it and flippantly commented 'I hope you aren't going in to neurosurgery.' Frank was so offended by the jab that he called the neurosurgery department that night and told him he accepted.

When I read this I literally took a second to scratch my head. Huh? He became a neurosurgeon to prove something to himself? It's certainly not a reason you would bring up in an interview (which it sounds like he didn't have to have). As a pre-med student, I'm starting to get various strings of advice, and some of them have to do with interviewing. We are constantly presented with the question: why do you want to be a doctor? There are the good reasons and then there are the not-so-good reasons. 'Because someone told me I can't' doesn't sound like it would impress anyone.

At the same time, the real world is different from what people say in interview settings. So while it bothered me a little why Frank originally went into neurosurgery, in the grand scheme of things, I don't think it mattered much. He was honest with us, and from the rest of the book it is clear that he cared for his patients and his profession at the level we would all hope from someone with such responsibility.

Dr. Vertosick goes into great detail on some of the surgical procedures he was apart of. Having recently observed a few neurosurgeries myself, I especially enjoyed these pieces. One of them I'd even seen in person. With just about all of the procedures he described, he also told the backstory of the patient. He used these as examples of the many lessons he learned throughout his residency, such as being a surgical psychopath, not being too confident, and that no matter how bad a patient is, you can always make him or her worse.

I really clicked with the commentary on surgical psychopathy. It's an aspect of being a physician I am both apprehensive and understanding of. On the one hand, I never want to become the type of person who is unaffected by death, or who looks at the patients as just numbers on a chart or another procedure. If I make a decision that ends a person's life, I don't want to be able to shrug it off, go have a beer, and forget about it the next day. On the other hand, I don't take death well (at all) and I realize it will be extremely taxing on me as an individual if I let each mortality hit home. Will I be able to strike a balance? Can I gain some of the psychopathy without crossing totally over to the other side?

From reading When the Air Hits Your Brain, it seems that Dr. Vertosick has walked the line and has ended up somewhere on the caring side. There was a particularly heart-wrenching case of a newborn with a brain tumor. They worked on the infant but the tumor was so deep that the damage done to remove it was seemingly irreversible. That, and the cancer would almost certainly remit. The advice to the parents was to say their goodbye's and not come back, move on with their lives as soon as they could, as there was nothing that could be done for the child and the longer they lingered, the longer it would take to try again in starting a family. But the baby ended up living longer than expected, and had more cognitive development than expected. She was soon able to laugh and play, and Frank visited her often. As predicted, however, the cancer came back to take her. Before it did, though, Frank spent nearly a whole day with her. He says he will always remember how, in those moments, he was the most important person in the world to her.

What more fulfillment could you get in a profession?

There were other stories just as thought-provoking, but I don't want to spoil it all here. I have a few areas of critique, as is inevitable with any public piece of work.

For one, the narrative seemed a little rushed at points. For example, I think he went from his first days as an intern to his third year of residency at the turn of the chapter. Or, at least, I was temporarily confused about the progression. All of a sudden he seemed very comfortable in his environment, and the story quickly migrated from telling of his personal transition to focusing on the patients. I was wondering where his confidence had come from, and at what point he went from feeling like a clueless med student/new physician to a surgeon who could challenge the knowledge of other people.

I must admit that I felt a little disappointed by the amount of detail left out concerning the lifestyle of a surgeon. When I picked this book up, I was hoping to come away with a better understanding of how residency is for someone who chooses this profession. I'm getting married in December, and one of my main apprehensions about surgery (and especially neuro) is the demanding lifestyle, and if I can be successful in both my career and my family at the same time. Dr. Vertosick mentioned his girlfriend/eventual wife only a few times, and those were in passing. I was wondering how he maintained the relationship during, or what arguments and hardships might have come out of the lifestyle he chose? When did he get married and how did that affect his career? How did he deal with the long hours of being a surgeon, and was he able to balance work with other aspects of his life? None of that was in there. I can see why the decision was made to keep the focus on the patients and the procedures, as that is more exciting for the average reader, but I came away feeling like I only got one side of the life of a resident: in the hospital.

Still, Dr. Vertosick writes with care, detail, and a poignant grasp of humanity. He is a person who rips people apart and puts them back together, sometimes with dire results, and he knows it. It really is amazing the types of things he has done, and for that I recommend this book to anyone who can read. Sure, it's about being a doctor, but it's about being human more than anything else. And who can't relate to that?

Tommyknockers - Good, but not King's best.

Tommykockers, tommyknockers, knocking on your door....

I still don’t know what the tommyknockers had to do with this story, but it made for a cool name. Actually, I do 'know.' Jim Gardener, the closest thing to a main character, was thinking about the Tommyknockers when all this started, and it stuck. In my opinion, it was incorporated a little weirdly. It seems like it was just a good, intriguing title for the book.

But on to the story. To me, Stephen King is the master of small-town tales. Salem’s Lot, IT, his latest Under the Dome. To some degree, I even consider The Stand as in the same category. It was far from small town, but it had the same large cast of characters that King developed throughout the book. And that's what I love about these stories. If you notice, all of the books listed about are more than 700 pages, three of them breaching the 1000 page mark. King spends ample time building a diverse ad interesting cast of characters and then plunge them into bizarre situations.

The Tommyknockers is definitely a smalltown novel. And, clocking in at just under 750 pages, it has the length. I thoroughly enjoyed it for that. Still, it was my least favorite out of the ones I’ve mentioned.

Let’s look at IT. That book was as much about Derry as it was about Pennywise the clown. Through a thousand pages, you got to know the town, its people, and what made it special. And you had six main characters whom each had their specific personalities, quirks, and downfalls. The story got a little bizarre (especially towards the end), but it didn't really matter but the characters were ucking fawesome.

With The Tommyknockers, I didn’t come out feeling like I had gotten close to knowing that many people, and Haven didn’t taken on the same reality that Derry had. Some of the side stories were interesting, such as the kid who made his brother disappear (permanently) during a magic trick, or the police officer who gave her life to alert the outside world of what was happening in Haven. But I don't think it was focused enough. I wasn't sure that Jim Gardener was supposed to be the main character until more than halfway through. With his drinking problem, his resistance to the power of the ship, and his many internal conflicts, he was interesting enough. But his partner, Bobbi Anderson, was honestly a little boring. I kind of just wanted her to die.

And what about her sister? Sister Anne? Trying too hard, Stephen? He does those rough, malicious characters pretty well, but usually they are three dimensional. Anne Anderson was basically King saying, how vile can I make a female who isn't breaking the law? Even to the end of her life she was snarling like a rabid dog and it's like...really? Do people like this really exist?

The story got a little weird at times, but most of King's stories do. He's a great tale-weaver, but when you zoom away, some of his stories sound a little...off. But that's how the real world is, isn't it? He stays true to what could really happen in extraordinary situations, even if it leaves us wondering...what the fuck? In the end, he delivers the goods where it matters: character development and scaring the shit out of you with his wonderful tension. The Tommyknockers missed the mark on these elements at time, but then again I'm comparing it to other King works, so it had a tough grading rubric to begin with.

House of Leaves

Short version: Shit was crazy!

Longer version: Shit was crazy!

That was one crazy book. If you take an academic thesis, a horror story, and a journal of a psychomaniac, throw them in a blender, and choose 'liquefy,' you'd get House of Leaves....after you let it sit for a while, of course.

At it's core, the book is about a house that is bigger on the inside than it appears on the out. This is a complete understatement, as points in the novel, this house holds corridors that rival the diameter of the Earth itself. Still, a fairly simple story, right? Well, the next layer is that this is actually a story about a blind man's experience with the story of the house (presented through film). Not done yet. There's another guy, who finds the writings on the old bling guy after his death, and he adds footnotes detailing not only his own thoughts about the text, but aspects of his adequately troubled life.

It's an interesting read, if not frustrating at times. The Navidson Record--written by the old bling guy--is a combination of straight narrative and analytic essay, complete with footnotes. It can quickly go from feeling like you're reading a regular novel to a paper for a college psychology course. The weirdest part (and maybe I just missed the explanation somewhere in the text) is that this dude is supposedly writing all this shit down about a documentary....but he's blind. It's like a deaf guy doing an analysis on the opera.

After about 100 ages, the report gets even weirder. Format goes out the window. You'll have footnotes at the top of the page, whole blocks of text missing, pages with only one paragraph, one sentence, one WORD....crazy shit, like I said.

Johnny Truant finds the scattered papers of The Navidson Record and adds his own two cents as more footnotes. We get a glimpse into his life--lots of sex, drugs, and mental problems--which gets progressively worse. He is suffering ill effects from reading The Navidson Record, like nightmares he can't remember, paranoia, and the inability to do anything in life but wallow in his own depression.

Johnny also has some of the hardest parts to get through. At times he just rambles on, stream of consciousness. It paints a great picture of his mental state, but it's jarring to try and get through 3 pages that's only about one or two sentences (I shit you not). He gets caught up on a topic or a thought or an experience, and keeps going and going until you can't really understand what he is saying anymore, when the thoughts have become more imagery than narrative facts, leaving the reader lost in a sea of words that change, deform, devour all mental states until the brain can't take anymore, yelling for freedom, yelling for some kind of peace, or maybe not yelling at all but wandering off to some other place while the eyes are left with the job of scanning the words but never really processing them, hundreds and hundreds of ideas, thoughts, emotions, wasted like a drunken whore.

Yeah....something like that.....times 10. I literally groaned everytime I turned a page and saw that it was another episode of Johnny's ramblings.  It's a shame, too, because I would usually blank out during these times, and I might have missed some deep insights.

As for scare factor, I've heard people say it's a really creepy book. It is, but it also has too much going on for me to really feel the brunt of that fear. The most disturbing part by far is not even a part of the main narrative. It is a collection of letters Johnny's mother sent him from an insane asylum. Now THOSE will leave an imprint on you, especially an encoded section that describes unmentionable horrors. For this alone, the author gains loads of credibility in the genre of horror in a way that's believable and disturbingly real.

I'm not going to go on too much about this book, but know that I enjoyed the experience and think that it's one of those rare gems where multiple readings will do it the most justice. If you decide to pick up the book, think of it more as a piece of art then the conventional word-laced entertainment. It's not something you can jet through. Even if you could, by doing do you'd be missing half the fun.

Under the Dome Review at TheCelebrityCafe.com

You can find it here: Under the Dome by Stephen King: A Review

I thoroughly enjoyed reading it and may write more about it here later. Next book: House of Leaves.

Misery by Stephen King - Review

Am I twisted if I finish a book like this and then think: wow, that was a fun ride! Some might say that I am, but I just like to think of it as recognizing a brilliant creative mind when I see one. Throughout, this novel was classic King, with all the twists, bloody details, and character development expected from the master. It was also interesting to read this after having watched the movie in the past. I thought the Annie in that was a psycopath, but King's original character takes the insanity cake, licks off all the icing, and then spits it back out before serving it to her guests. I don't know if I have ever encountered a crazier character, written or acted, than Annie Wilkes.

King decided to present this story through the perspective of a writer, something he has done in other novels (The Shining, The Dark Half, Lisey's Story, etc) with great outcomes. Misery is no different. Throughout the novel, King explores what it means to be a writer, from dealing with motivations to writer's block to pushing past the slush and the frustration to break free into the land of the wonderful. He does this through Paul Sheldon, a famous author of the Misery books, a romance series based in pre-colonial times. He owes his fame to these books, but he is also trying to escape them and write that novel to become known as a more 'serious' author. After completing the first draft of this savior novel, he takes it upon himself to celebrate and the next thing he knows he is drugged and in a lifetime of pain in the home of Annie Wilkes: he had been in a near-fatal accident on a snowy, windy road in the dead of winter. By chance, luck, or some strange fate, Annie had been the one to find him. And Annie is his biggest fan. And Annie is crazier than a pitbull with hot sauce on its nuts.

The rest of the novel focuses on Annie and Paul's interactions. We slowly, but surely, see her psychotic nature unfold as she first becomes furious at Paul for killing Misery Chastain at the end of the last book in the series that just came out and later forces Paul to burn his new manuscript and write Misery's Return in its place. I'm not going to give away the details of her grand displays of dementia, but King does a great job of creating a desperate and bone-chilling environment for the duration of the reader's stay.

This novel only contains two main characters and one setting. And even in that one setting (Annie's house), we are mostly limited to one bedroom. This allows a greater focus on the development of these two characters. We learn what makes Paul Sheldon tick as a writer an, in turn, some insight into the mind of King as well. One thing that stuck out to me was Paul's recurring question of Can You? He uses this as motivation to get past his writer's block, to tell himself that he can create worlds and characters that people can relate to. He has a lot of time to think in this book--about life, mortality, writing, and the f'ed up situation he's found himself in--and this is one of his answers to his own infamous question:

"Can I? Yeah. You bet I can. There's a million things in this world I can't do. Couldn't hit a curveball, even back in high school. Can't fix a leaky faucet. Can't roller skate or make a F-chord on the guitar that sounds like anything but shit. I have tried twice to be married and couldn't do it either time. But if you want me to take you away, to scare you or involve you or make you cry or grin, yeah. I can. I can bring it to you and keep bringing it until you holler uncle. I am able. I can."

In conclusion, Misery is a great ride. Even if not a horror fan, anyone who has any interesting in writing should try to stomach the grotesque and the terror for some damn good commentary on what it means not only to thrive in this art but to live it to its fullest.

Book Review: The Talisman by Stephen King & Peter Straub

I first started this book when I was around 10 years old and didn't get far in it at all. I don't know the reason (actually, there were a few Stephen King books I started back then but never got around to finishing....maybe my brain just wasn't ready yet), but I picked it up again a few weeks ago and the ride has been awe-inspiring and a real testament of the imagination.

Meet Jack Sawyer, a 12-year-old boy who's tall for his age. At the age of 6 he had to deal with his father's death and now cancer is eating away at his once-Hollywood-star mother. In a hotel in New England he knows that his mother is waiting to die, and it seems like there is nothing in the whole damn world that he can do about it. Until he discovers that there is this other world waiting for him. This world where his mother is someone important and her death would be mean destruction and chaos. A world where Jack is the only one with the power to be the hero.

The Talisman is one boy's quest to find, well, a magical talisman to save his mother's life. He must do this by traveling from coast to coast while discovering horrors both in the world and the next--the Territories. The novel really shines in its imagination. Nothing is spared here--King and Straub bring out all the sparks. Every environment Jack encounters (and there are a lot) is rich in originality and just as scary in it grimy detail. And, surprisingly, some of the scariest things are found in this world rather than the next. And that is where the writing really hits home, when it's not some dark wizard, demented ghoul, or led astray werewolf that is terrorizes the town, but rather the good 'ole, reliable stench of human nature. The characters that Jack meet are all colorful and wholly distinguishable. From the bordlerline cowardly cousin who just can't for the life of him accept magic and parallel universes and all of the crazy stuff happening in front of his eyes, to the werewolf we come to have more of an emotional connection to than most humans we meet in novels, to the main villain, whose evil persona has no redeeming qualities: anything that was ever good in him died a long time ago. Even characters that are just passing by have memorable qualities and little unique quirks that show both the horror and glory of the human spirit.

This brings me to a point about characterization that I notice in a lot of King's works. His world is bad. And what I mean by this is humanity's ugliness exists in a lot of King's characters, and this book is no different. While in other novels/movies it seems that the majority of people a main character meets has more good than bad, it is backwards with King. Along the way, Jack comes across child molesters, crooked cops, men who beat their wives, their children, drug addicts, religious zealots that kill in the name of the lord, etc, etc, etc. Even other kids around Jack's age seem to have deep-rooted inherent evil. A typical character in this world is rough around the edges, has seen some pretty f'ed up things in their lives, and most likely looking out for themselves. This makes it so that the main villains have to REALLY do some crazy stuff to stick out in the reader's mind and anyone that is a genuinely good person/being also has a last effect. It comes to a point where the child molesters and wife-beaters almost become forgettable because they are the status-quo. It makes for an interesting read, but it makes me wonder about the King's background. I don't know how much this is attributed to Straub, but it's something I notice in a lot of King's works.

Or maybe the world isn't as sugar coated as I see it.

The writing is fantastic, as always. King has a way of going deep into his characters, sometimes veering off right at a heart-wrenching part to relate to some part of the character's past, often shedding a brand new light on what is happening in the present. Also, even though the book follows Jack Sawyer, it has little interludes where it switches to the perspective of other characters, sometimes the main villain himself.

One thing that I didn't care for so much was the use of time. King/Straub would often start a new chapter 3 or 4 days from where the last chapter (just a turn of a page) left off, with the main character in a completely different mindset because of the harrowing and yet-to-be-known events of the last few days. This makes for some heightened interest from the reader, but I often found myself confused and having to backtrack as the authors would almost go backward to catch the reader up. A lot of times during these points in the story I didn't know exactly at what point in the time lines the things that I was reading had happened. Fortunately, though, telling events in this fashioned wasn't used too much and were more so in the middle of the novel. Now that I think about it, it was almost like an experiment that the authors decided wouldn't be good for the whole book but decided to leave remnants of anyway.

All in all, without spoiling too much, The Talisman is a great read. The things that you will see in this book (and trust me, you WILL see them) will stretch and fold your imagination, sometimes making you cringe, sometimes making you laugh, and sometimes making you just have to take a break from reading for a moment, not because it's bad, but because your brain may need to recover from the overload. I'm glad I was able to finally finish the journey that I started some 10 years ago and my only regret is that it's over.